Abstract
Purpose :
The purpose of this study was to develop and applicate of new fix and follow grading system for quantitative assessing the visuo-cognitive system development in preverbal children.
Methods :
We made the fix and follow grading system. Fixation was investigated based on saccadic eye movement, grade1; no response to target, grade2; response to target but not last more than 3 seconds, grade3; satisfy one of the following criteria, grade4; satisfy all the following criteria; (1) fix the target lasting more than 3 seconds (2) move gaze from one target to another. Follow was evaluated on smooth pursuit movement within horizontal 30-degree ranges, grade1; absent movement, grade2; partial movement, grade3; complete movement. Two well-trained ophthalmologists evaluate the fix and follow grade of infants under 36 months of age who did not cooperate with the visual acuity test. One ophthalmologist re-evaluated the grading scales within 4 weeks. Inter-observer and intra-observer reliability for fix and follow grade were investigated.
Results :
Twenty-one consecutive preverbal children were included. Intra-observer reliability was very good (r= 0.95, 95% CI 0.95 – 1.0) while inter-observer reliability was moderate (r= 0.51, 95% CI 0.21 – 0.81). When comparing the patients with a different fixation grade between examiners with those who did not, limitation in the ocular movement was significantly more frequent in the patients with grade disparity (p=0.021, Mann-Whitney U).
Conclusions :
This new fix and follow grading scale in preverbal children can be easily applied in the office setting. This method may be more reliable method when longitudinal follow-up by the same examiner, however, the grading and interpretation should be careful in patients with ocular motility disorder.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.